O-50 Conversing across the cultural divide – advance care planning (ACP) with culturally and linguistically diverse (CALD) patients

Abstract

Background Australia is ethnically diverse, a quarter of the population are born overseas. It is recognised that ACP uptake in CALD population is poor. Reasons include lack of inlanguage resources and cultural differences including the notion of patient autonomy and the role of the family. Aim To determine the feasibility and uptake of ACP in the Greek and Italian born population presenting to the Austin hospital. Methods A prospective cohort study, competent Greek or Italian speaking patients aged > 65 were offered ACP from a trained nurse facilitator. Inlanguage ACP brochures and ACP educated interpreters were provided. Control patients were competent English speaking patients. Results 25 Greek, 24 Italian and 63 English-speaking patients were recruited with similar demographics. Each group had a median of 2 visits and the median ACP conversation time was similar (88 mins- CALD versus 80). Interpreter services were utilised in 29% of conversations with no difference in outcomes. There was no difference in the rate of completion of Advance Care Directives (55% CALD, 56% Control). Involvement of the family was more prevalent with CALD patients and was associated with increased documentation of wishes. Discussion This study demonstrates that the myths regarding ACP in CALD patients, including a lack of interest, cultural differences and time taken, are not correct. Using a trained ACP facilitator and involving family, the acceptance of ACP, time taken to completion and documentation of wishes were all comparable to English speakers. Conclusion Given the appropriate resources CALD patients will use ACP services.